HomeMy WebLinkAboutOTH Record Requests - 12/11/2008 RECEIVED
_Mason County Public Records Request Form
426 W. Cedar Street, PO Box 186, Shelton WA. 98584 K
Phone: (360) 427-9670 X-352 Fax: (360) 427-7798
I would like information: Mailed_Faxed Picked Up_Date: e4o x
Y Requesters Name: A-CWACtA-
Company Representing:
Address: Email:
City: � / State: Zip:
/
X Phone: � O d� l0Zg Fax:
�( Parcel NoZ 2 a 3 a - 5:--P-
Parcel Address:
Owner: U VV`OL4&--- Previous Owner
Please Provide Records For The Following:
Environmental Health X Planning Dept. Building Dept.
Please specifically describe what records or kind of records you are requesting:
RCW 42.56 I certify that the information obtai e ' this request ' 1 not s d for
commercial purposes. Signature Required:
Requests may be charged per RCW 42.56. During file review any pagits you wish to
have copied(excluding non public record documents)must be tagged and charges will
be assessed at.15 cents per copy. Larger than 8.5"x I I"will be charged at a higher rate
as established by Mason County resolution.
In addition to the per copied page fee standard postage rates will apply.
Make Checks Payable To: Mason County Treasurer; Total Fees Due:
fficial Use Onl
Completed By A 00 0 A Ext. Date: f In
Notes:
*Please allow 5 business days for us to respond to your request*
If items are being mailed please allow an additional 3 days until you receive the request submitted.
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